Long-term clinical outcomes following the central incision technique for insertional achilles tendinopathy

2012 ◽  
Vol 10 (1) ◽  
pp. 80
Keyword(s):  
Clinical Outcomes ◽  
Achilles Tendinopathy ◽  
Incision Technique ◽  
Insertional Achilles Tendinopathy

scholarly journals Comparison of dorsal closing wedge calcaneal osteotomy versus posterosuperior prominence resection for the treatment of Haglund syndrome

2020 ◽  
Author(s):  
Zilu Ge ◽  
Lin Ma ◽  
Hong Tang ◽  
Mingyu Yang ◽  
Aining Yang ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Achilles Tendinopathy ◽  
Common Disease ◽  
Short Term ◽  
Closing Wedge ◽  
Calcaneal Osteotomy ◽  
Significant Difference ◽  
Böhler’S Angle

Abstract Background: Haglund syndrome is a common disease that causes posterior heel pain. This study compared the clinical outcomes of dorsal closing wedge calcaneal osteotomy (DCWCO) and posterosuperior prominence resection (PPR) for the treatment of Haglund syndrome.Methods: This retrospective study included 12 patients who underwent DCWCO and 32 patients who underwent PPR from January 2010 to August 2016. Patients were evaluated using the American Orthopedic Foot Ankle Society ankle-hindfoot scale (AOFAS), Victorian Institute of Sport Assessment Scale for Achilles tendinopathy (VISA-A), Fowler-Philip angle, Bohler’s angle, and calcaneal pitch angle preoperatively and postoperatively (at 3 months, 6 months, 1 year, and the latest follow-up). Results: Both groups exhibited a significant increase in their AOFAS and VISA-A scores after surgery. The DCWCO group had lower AOFAS scores than the PPR group at 6 months (77.6 ± 5.1 vs. 82.8 ± 7.8; P =0.037) but had higher scores at the latest follow-up (98.2 ± 2.3 vs. 93.4 ± 6.1; P =0.030). The DCWCO group had lower VISA-A scores at 3 months (56.9 ± 13.9 vs. 65.2 ± 11.0; P =0.044) but higher scores at the latest follow-up (98.2 ± 2.6 vs. 94.3 ± 5.0; P =0.010) than the PPR group. Both groups exhibited significant changes in the Fowler-Philip angle and Bohler’s angle after surgery. The postoperative Fowler-Philip angle of the DCWCO group was greater than that of the PPR group (35.9° ± 4.9° vs. 31.4° ± 6.2°; P =0.026). However, there was no statistically significant difference in any other angle of the two groups postoperatively.Conclusions: Compare to PPR group, the DCWCO group had poorer short-term clinical outcomes but provide better long-term function and symptom remission. This method can be a good option for those patients with higher functional expectations.

Long-term clinical outcomes of the single-incision technique for implantation of implantable venous access ports via the axillary vein

2017 ◽  
Vol 18 (4) ◽  
pp. 345-351 ◽  
Author(s):  
Tae-Seok Seo ◽  
Myung Gyu Song ◽  
Jun Suk Kim ◽  
Chul Won Choi ◽  
Jae Hong Seo ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Single Incision ◽  
Venous Access ◽  
Brachiocephalic Vein ◽  
Central Vein ◽  
Axillary Vein ◽  
Medial Side ◽  
Incision Technique ◽  
Subcutaneous Tunneling

Purpose To evaluate long-term clinical outcomes and complications of the single-incision technique for implantation of totally implantable venous access ports (TIVAPs) via the axillary vein. Materials and Methods A total of 932 TIVAPs were placed in 927 patients between May 2012 and October 2014 using a single-incision technique. Patients included 620 men and 307 women with a mean age of 60.0 years. TIVAPs were placed via the left (n = 475) and right (n = 457) axillary veins after making a single oblique vertical incision and medial side pocket without subcutaneous tunneling. We retrospectively reviewed medical records to evaluate status of the patients and TIVAPs, complications, and reasons for explantation. In patients who still had a TIVAP in place, we calculated the duration of TIVAP use from the cut-off day of November 1, 2015. Results Clinical follow-up was obtained for a total device service period of 311,069 days with a median indwelling time of 467 days (range: 3-1097 days). A total of 37 (4.0%) complications developed. Early complications (n = 4) were one case each of stenosis of the brachiocephalic vein by tumor growth, thrombosis of axillary vein, intravascular migration, and malfunction depending on patient's position. Late complications (n = 33) were suspected catheter-related blood stream infection (n = 23), local infection of the pocket (n = 4), symptomatic stenosis and thrombosis of central vein (n = 4), malfunction by fibrin sleeve (n = 1), and intravascular migration (n = 1). Conclusions A single-incision technique for TIVAP implantation via the axillary vein seems to be safe with a low risk of complication.

Long-term beneficial effects of platelet-rich plasma for non-insertional Achilles tendinopathy

2015 ◽  
Vol 21 (3) ◽  
pp. 178-181 ◽  
Author(s):  
Matteo Guelfi ◽  
Andrea Pantalone ◽  
Daniele Vanni ◽  
Michele Abate ◽  
Marco G.B. Guelfi ◽  
...  
Keyword(s):  
Platelet Rich Plasma ◽  
Achilles Tendinopathy ◽  
Beneficial Effects ◽  
Insertional Achilles Tendinopathy

scholarly journals Comparison of a dorsal closing wedge calcaneal osteotomy versus a posterosuperior prominence resection for the treatment of Haglund syndrome

2020 ◽  
Author(s):  
Zilu Ge ◽  
Lin Ma ◽  
Hong Tang ◽  
Mingyu Yang ◽  
Aining Yang ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Achilles Tendinopathy ◽  
Common Disease ◽  
Short Term ◽  
Aofas Score ◽  
Closing Wedge ◽  
Calcaneal Osteotomy ◽  
Böhler’S Angle

Abstract Background Haglund syndrome is a common disease that causes posterior heel pain. The objective of this study was to compare the clinical outcomes between the dorsal closing wedge calcaneal osteotomy (DCWCO) and the posterosuperior prominence resection (PPR) for the treatment of this disease. Methods The retrospective study included 12 patients who received DCWCO and 32 who patients received PPR from January 2010 to August 2016. The patients were evaluated in terms of the American Orthopedic Foot Ankle Society ankle-hindfoot scale (AOFAS), the Victorian Institute of Sport Assessment Scale for Achilles tendinopathy (VISA-A), the Fowler-Philip angle, Bohler’s angle, and the calcaneal pitch angle, both pre- and postoperatively (at 3 months, 6 months, 1 year, and the latest follow-up). Results Both groups showed a significance increase in their AOFAS and VISA-A scores after the operation. The DCWCO group showed a lower AOFAS score than the PPR group after 6 months (77.6 ± 5.1 vs. 82.8 ± 7.8, P =0.037), but received higher scores in the latest follow-up (98.2 ± 2.3, vs. 93.4 ± 6.1, P =0.030). For the VISA-A scores, the DCWCO group had lower scores for 3 months (56.9 ± 13.9, vs. 65.2 ± 11.0, P =0.044), but showed higher scores in the latest follow-up (98.2 ± 2.6, vs. 94.3 ± 5.0, P =0.010) when compared with the PPR group. Both groups had a significant change in the Fowler-Philip angle and Bohler’s angle after the operation. The postoperative Fowler-Philip angle in the DCWCO group was greater than that of the PPR group (35.9° ± 4.9°, vs. 31.4° ± 6.2°, P =0.026). However, there was no statistical difference in any other angle between the two groups, postoperatively. Conclusions The DCWCO group had poorer short-term clinical outcomes but better long-term function and symptom remission, as compared with the PPR group, in the treatment of Haglund syndrome.

scholarly journals Deep phenotyping classical galactosemia: clinical outcomes and biochemical markers

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Mendy M Welsink-Karssies ◽  
Sacha Ferdinandusse ◽  
Gert J Geurtsen ◽  
Carla E M Hollak ◽  
Hidde H Huidekoper ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Newborn Screening ◽  
Clinical Outcomes ◽  
Movement Disorders ◽  
Brain Mri ◽  
Primary Ovarian Insufficiency ◽  
Ovarian Insufficiency ◽  
Classical Galactosemia ◽  
Intellectual Outcome

Abstract Early diagnosis and dietary treatment do not prevent long-term complications, which mostly affect the central nervous system in classical galactosemia patients. The clinical outcome of patients is highly variable, and there is an urgent need for prognostic biomarkers. The aim of this study was first to increase knowledge on the natural history of classical galactosemia by studying a cohort of patients with varying geno- and phenotypes and second to study the association between clinical outcomes and two possible prognostic biomarkers. In addition, the association between abnormalities on brain MRI and clinical outcomes was investigated. Classical galactosemia patients visiting the galactosemia expertise outpatient clinic of the Amsterdam University Medical Centre were evaluated according to the International Classical Galactosemia guideline with the addition of an examination by a neurologist, serum immunoglobulin G N-glycan profiling and a brain MRI. The biomarkers of interest were galactose-1-phosphate levels and N-glycan profiles, and the clinical outcomes studied were intellectual outcome and the presence or absence of movement disorders and/or primary ovarian insufficiency. Data of 56 classical galactosemia patients are reported. The intellectual outcome ranged from 45 to 103 (mean 77 ± 14) and was <85 in 62%. Movement disorders were found in 17 (47%) of the 36 tested patients. In females aged 12 years and older, primary ovarian insufficiency was diagnosed in 12 (71%) of the 17 patients. Significant differences in N-glycan peaks were found between controls and patients. However, no significant differences in either N-glycans or galactose-1-phosphate levels were found between patients with a poor (intellectual outcome < 85) and normal intellectual outcome (intellectual outcome ≥ 85), and with or without movement disorders or primary ovarian insufficiency. The variant patients detected by newborn screening, with previously unknown geno- and phenotypes and currently no long-term complications, demonstrated significantly lower galactose-1-phospate levels than classical patients (P < 0.0005). Qualitative analysis of the MRI’s demonstrated brain abnormalities in 18 of the 21 patients, more severely in patients with a lower intellectual outcome and/or with movement disorders. This study demonstrates a large variability in clinical outcome, which varies from a below average intelligence, movement disorders and in females primary ovarian insufficiency to a normal clinical outcome. In our cohort of classical galactosemia patients, galactose-1-phosphate levels and N-glycan variations were not associated with clinical outcomes, but galactose-1-phosphate levels did differentiate between classical and variant patients detected by newborn screening. The correlation between brain abnormalities and clinical outcome should be further investigated by quantitative analysis of the MR images. The variability in clinical outcome necessitates individual and standardized evaluation of all classical galactosemia patients.

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